Description

Gendreau et al reported a nomogram for predicting the risk of poor outcome for a patient with systemic vasculitis with gastrointestinal tract involvement. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in France and members of the French Vasculitis Study Group.


Patient selection: systemic vasculitis with gastrointestinal involvement

 

Poor Outcome: ICU admission, surgery for worsening disease, or death within 6 months

 

Parameters:

(1) type of vasculitis

(2) ECOG performance status

(3) use of morphine

(4) ileus

(5) guarding

(6) melena

(7) WBC count from 0 to 60 * 10^9/L

(8) hemoglobin in g/dL from 4 to 22

(9) CRP in mg/L from 0 to 450

 

points for hemoglobin =

= 122.22 - (5.56 * (hemoglobin))

 

points for WBC count =

= 1.193 * (WBC)

 

points for CRP =

= (4.831 * LN(CRP)) - 0.1831

 

Parameter

Finding

Points

type of vasculitis

IgAV

0

 

PAN

28.1

 

other

18.9

ECOG performance

0

0

 

1

8.36

 

2

16.72

 

3

25.08

 

4

33.45

morphine

no

0

 

yes

22.7

ileus

no

0

 

yes

28.1

guarding

no

0

 

yes

20.7

melena

no

0

 

yes

25.1

 

total score =

= SUM(points for all of the parameters)

 

Interpretation:

• minimum score: 0

• maximum score> 359.1

 

value of X =

= (0.04 * (score)) - 5.847

 

probability of poor outcome =

= 1 / (1 + EXP((-10 * X))

 

Performance:

• The area under the ROC curve is 0.85.


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